Plastic and Reconstructive Surgeon

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A neck lift, or lower rhytidectomy, is a surgical procedure that improves visible signs of aging in the jawline and neck, such as: Excess fat and skin relaxation in the lower face that creates jowls Excess fatty deposits under the chin Loose neck skin Muscle banding in the neck, which creates abnormal contour

The loss of youthful contour in the face and neck can be due to a variety of factors, including hereditary predispositions, gravity, environmental conditions, and stress.
Some people feel they are not ready for a full facelift because the upper face is still pleasing. However, many patients will note excess wrinkling of the neck skin, a “turkey wattle” or double chin, and jowl lines. When the neck area doesn’t match the upper facial appearance, a neck lift may be a good solution.
Rejuvenation procedures that can be performed in conjunction with a neck lift are: a brow lift, to correct a sagging or deeply furrowed brow, fat transfer, to add fullness to the lips and cheeks and reduce the appearance of wrinkles, or eyelid surgery, to rejuvenate aging eyes.
As a restorative surgery, a neck lift does not change your fundamental appearance and cannot stop the aging process.
A neck lift can only be performed surgically; non-surgical rejuvenation treatments cannot achieve the same results but may help delay the time at which a neck lift becomes appropriate and complement the results of surgery.

Procedure

Neck lift procedure is usually performed under general anaesthetic. In certain cases, it may be performed under sedation and local anaesthesia. Depending on the degree of change you’d like to see, your neck lift choices include a traditional neck lift incision or a limited incision neck lift.
Traditional neck lift incision often begins in the hairline at the level of the sideburn, continues down and around the ear and ends in the posterior hair. Fat may be sculpted or redistributed from the jowls and neck. The tissue underlying the neck skin is repositioned, and commonly the platysma muscle is tightened. Skin is redraped over the uplifted contours and excess skin is trimmed away. A separate incision under the chin is often necessary for liposuction of this area and for repair of the muscle.
Limited incision neck lift may involve incisions only around the ear. While the incisions are shorter, the results may be more limited.
Incision lines are closed with dissolvable sutures. Once healed, the incision lines from a neck lift are usually well concealed within the hairline and in the natural contours of the ear. The visible improvements of a neck lift appear as swelling and bruising subside. Your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself.
During your recovery from neck lift surgery, a bandage could gently be placed around your face and neck to minimize swelling and bruising when your procedure is completed. A thin tube may be present to drain any excess blood or fluid that may collect under the skin. You will be given specific instructions that may include how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.
It is important to keep your head elevated above your heart to minimize swelling and to keep your head straight (no excessive twisting or bending of the neck). DO NOT APPLY ICE to the neck as this can compromise blood supply to the skin.
It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Avoid wearing any clothing that must go over your head. Your doctor will give you specific instructions on how to care for yourself.
As you begin to evaluate your neck lift results, please remember that it may take several weeks to months for swelling to fully dissipate and 12-18 months for incision lines to mature. During this time, you can improve the appearance of the scars by following a scar management protocol provided by Dr. Grubnik.
After surgery, it is often possible to return to work within a couple of weeks, depending on your job. It is recommended to refrain from driving for seven to ten days after surgery. In many instances, you can resume most of your normal activities after a few weeks. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal. Severe pain should be reported to Dr. Grubnik. Any sexual activity should be avoided for a minimum of one week, and your plastic surgeon may advise you to wait longer. It is recommended to avoid exercise for six weeks.
As swelling and bruising subside, the visible improvements of a neck lift appear. Your final result should not only provide a more youthful and rested appearance, but also help you feel more confident about yourself. Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Life-long sun protection, appropriate skin care regimen and a healthy lifestyle will help extend the results of your rejuvenated, more youthful appearance.
Following your plastic surgeon's instructions is essential to the success of your surgery.

Indications

In general, good candidates for a neck lift include:

Healthy individuals who do not have medical conditions that impair healing
Non-smokers
Individuals with a positive outlook and realistic expectations
During your neck lift surgery consultation, be prepared to discuss:

Your surgical goals
Medical conditions, drug allergies and medical treatments
Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
Previous surgeries
Your neck lift surgeon will also:

Evaluate your general health status and any pre-existing health conditions or risk factors
Discuss your rejuvenation options
Examine and measure your face
Take photographs
Recommend a course of treatment
Discuss likely outcomes of a neck lift and any risks or potential complications
Discuss the type of anaesthesia that will be used
Be sure to ask questions. It’s very important to understand all aspects of your neck lift. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.
In preparing for neck lift surgery, you may be asked to:

Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Stop smoking

Disadvantages / Complications

The decision to have a neck lift is extremely personal. You will have to decide if the benefits will achieve your goals, and if the risks and potential complications of a neck lift are acceptable. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications. It is important that you discuss all your questions directly with your plastic surgeon.
Neck lift surgery risks include:

Anaesthesia risks
Bleeding
Temporary or permanent hair loss along the incisions
Facial asymmetry
Rare nerve injury that could cause weakness of the lower lip
Fluid accumulation (hematoma)
Infection
Unfavourable scarring
Prolonged swelling
Skin irregularities and discoloration
Skin loss
Sutures may spontaneously surface through the skin, become visible or produce irritation and require removal
Numbness or other changes in skin sensation
Persistent pain
Poor wound healing
Rare risk of deep venous thrombosis with cardiac or pulmonary sequelae
Unsatisfactory results which may require revisional surgery

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